Capital Credits Beneficiary or Personal Representative’s Refund Request Form

This form is for beneficiaries who are claiming capital credits that were allocated to a SMECO member who is now deceased.

If you are a SMECO member and you wish to designate a beneficiary for your capital credits, fill out the Beneficiary Designation Form.

Deceased SMECO Member's Information

Deceased Member's Name(Required)
Last Known SMECO Service Address(Required)


Your Name(Required)
Your Date of Birth (mm/dd/yyyy)(Required)
Your Mailing Address(Required)
Refund options for beneficiary or personal representative(Required)
Max. file size: 400 MB.
Max. file size: 400 MB.
Max. file size: 400 MB.